Contamination of platelet concentrates with Staphylococcus aureus induces significant modulations in platelet functionality
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Basit Yousuf1,2, Roya Pasha1, Nicolas Pineault1,2
1Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.
Background And Objectives:
Platelet concentrates (PCs) contaminated with Staphylococcus aureus can escape detection during PC screening, causing septic transfusion reactions. This study aimed to determine the impact of S. aureus contamination on platelet metabolism and functionality during PC storage.
Materials And Methods:
Targeted metabolomics (N = 3) was performed on non-spiked PCs and PCs inoculated with 10-20 colony-forming units (CFU)/bag of S. aureus. Metabolites were quantified at 0, 48 and 144 h using high-performance mass spectrometry (MS). Additionally, PCs spiked with approximately 20 CFU/bag of S. aureus were sampled every 24 h for up to 144 h to evaluate platelet functionality using flow cytometry (N = 2).
Results:
Eight metabolites had significantly different levels in spiked PCs (log2 fold-change ≤ or ≥±1) versus non-spiked units at 48 and 144 h. Xanthine, uridine, serine, glutamine and threonine were increased, whereas orotic acid, dihydroorotic acid and aspartic acid were decreased. Flow cytometry showed a significant decrease in expression of GPIIb while P-selectin expression was significantly increased in spiked PCs after 72 h of storage when S. aureus concentration was ≥10E+08 CFU/ml. Additionally, phosphatidylserine exposure was significantly increased after 48 h of PC storage, when S. aureus had reached a concentration of 2E+06.
Conclusion:
Contamination with S. aureus exacerbates platelet storage lesions in contaminated PCs but only when the bacterium has reached clinically significant levels.
Insights
Staphylococcus aureus contamination in platelet concentrates (PCs) alters platelet metabolism and function, worsening storage lesions. These changes become significant only when bacterial levels reach clinically relevant concentrations.
Area of Science:
- Transfusion Medicine
- Microbiology
- Metabolomics
Background:
- Platelet concentrates (PCs) can be contaminated with Staphylococcus aureus, leading to septic transfusion reactions.
- Current screening methods may not always detect S. aureus contamination in PCs.
Purpose of the Study:
- To investigate the impact of S. aureus contamination on platelet metabolism and functionality during PC storage.
- To identify specific metabolic and functional changes in PCs due to S. aureus presence.
Main Methods:
- Targeted metabolomics using high-performance mass spectrometry on non-spiked and S. aureus-spiked PCs.
- Flow cytometry analysis of platelet functionality markers (GPIIb, P-selectin, phosphatidylserine exposure).
- Sampling at various time points (0, 48, 144 hours) during PC storage.
Main Results:
- Significant alterations in eight metabolites were observed in spiked PCs at 48 and 144 hours.
- Decreased expression of GPIIb and increased P-selectin expression occurred after 72 hours with high bacterial load.
- Increased phosphatidylserine exposure was detected after 48 hours, indicating platelet activation.
Conclusions:
- S. aureus contamination exacerbates platelet storage lesions in PCs.
- The detrimental effects on platelet metabolism and function are evident only when bacterial concentrations reach clinically significant levels.
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